Sunscreen and Melanoma

Is Our Prevention Message Correct?

Margaret B. Planta, MD

Disclosures

J Am Board Fam Med. 2011;24(6):735-739. 

In This Article

Abstract and Introduction

Abstract

Many primary care providers advise patients to use sunscreen as a means to reduce their risk for skin cancer, especially cutaneous malignant melanoma (CMM). Despite the availability and promotion of sunscreen for decades, the incidence of CMM continues to increase in the U.S. at a rate of 3% per year. There currently is little evidence that sunscreens are protective against CMM. A number of studies suggest that the use of sunscreen does not significantly decrease the risk CMM, and may actually increase the risk of CMM and sunburns. This paper discusses current information regarding the relationship between sunscreen use and CMM, and how providers may need to alter their advice regarding sunscreen use for CMM prevention.

Introduction

For years, primary care providers have advised patients to use sunscreen as a means to reduce their risk of skin cancer, especially cutaneous malignant melanoma (CMM). However, between 1973 and 2003, the incidence of CMM increased by 81% and continues to increase at a rate of 3% per year.[1] According to a 2006 US Environmental Protection Agency publication, "there is no evidence that sunscreens protect you from malignant melanoma."[2] A number of studies suggest that the use of sunscreen either does not significantly decrease the risk or may actually increase the risk of CMM.[3–7] Other studies indicate that sunscreen users, when compared with nonusers, may actually be more likely to develop sunburns, thereby possibly increasing their risk of CMM.[7–9] These studies, as well as the continued increase in rates of CMM, call into question whether our current advice regarding sunscreen use is truly beneficial in preventing CMM or if it may actually be detrimental in the fight against CMM.

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